Health care will continue to dominate the headlines in 2019 as the local hospital systems expand their footprints in Lee and Collier counties. Also, expect more stories about changes to state and federal government regulation of the industry.

Here are are some of the issues that are expected to make headlines in the coming year:

Three more hospitals for Lee and Collier counties?

The state Agency for Health Care Administration in June approved applications for three new hospitals in Lee and Collier counties, a dramatic reversal of the agency's opinion four years ago that the region did not need any more health centers.

A dizzying list of legal challenges to them filed by competing hospitals are expected to get their day in court in the early part of the coming year.

Tennessee-based HCA Healthcare has proposed an 80-bed hospital (10 of which would be for psychiatric care) on a site near Corkscrew Road and U.S. 41. Lee Health, the dominate hospital system in Lee County, hopes to build its own 82-bed health center on the site of the recently opened Lee Health at Coconut Point outpatient medical campus.

Braden Clinic has plans for a 25-bed hospital in the geographically isolated community of Ave Maria.

NCH Healthcare System and the Physicians Regional Healthcare System, which compete for patients in south Lee County, are opposing the Lee County hospitals. NCH also opposes the Ave Maria project. Lee Health and HCA are opposing each other's projects.

The final piece of the project will be relocating the region's trauma center from Lee Memorial Hospital near downtown Fort Myers to Gulf Coast. That's likely to happen sometime after 2020, said hospital system spokesman Jonathon Little.

Lee Health is spending nearly $348 million to expand Gulf Coast Medical Center in south Fort Myers. The project, which is expected to be finished in 2021, will include the addition of 268 patient beds and the relocation of the region's trauma center from Lee Memorial Hospital.
Frank Gluck/The News-Press

More mental health care?

Community leaders have long lamented the shortage of mental health services for children in Southwest Florida. In 2019, Lee Health hopes to address the problem with the launch of a limited mental health diagnostic screening program for children.

Children coming to the Golisano Children's Hospital and certain, still unspecified, Lee Health treatment centers will answer mental health questions to determine if they suffer from or are at risk of anxiety, depression or more serious illnesses.

Depending on their answers they may be referred to a computer program that can help teach coping skills for low-grade depression and anxiety. Children with more severe cases would be referred to a mental health counselor via video chat.

Lee Health's fundraising arm, the Lee Health Foundation, announced last month that it is launching a $10 million, three-year fundraising drive to support new programs for children suffering from mental illness.

Affordable Care Act challenge

A federal judge in Texas ruled this month that the health law commonly referred to as Obamacare was unconstitutional, a decision the courts are likely to take up in 2019.

According to USA Today, U.S. District Court Judge Reed O’Connor reasoned that the law became unconstitutional when Congress voted last year to end the tax penalties for people who did not get coverage when they were required to do so.

The Supreme Court upheld the law in 2012, citing the tax penalty. Thus, O'Connor ruled, the law became unconstitutional when it ended. For a more detailed explanation, click here.

The Democratic Party, which assumes control of the House of Representatives in January has vowed to fight for the law. If other courts uphold the decision, the matter could go before the Supreme Court this fall, USA Today reported.

New governor. New marijuana policies?

With the election of Republican Ron DeSantis as Florida's new governor, medical marijuana advocates are hoping to see the end of court challenges being waged by the Rick Scott administration and other regulatory footdragging.

In 2016, more than 71 percent of Floridians approved an amendment to the state's constitution to broadly legalize medical marijuana.

Lt. Gov.-elect Jeanette Nunez told The News Service of Florida earlier this month that DeSantis, who takes office Jan. 8, “has said he’s not interested in continuing that fight.”

As of last week, more than 165,000 Floridians qualified as cannabis patients. More than 1,900 physicians in the state are authorized to prescribe it.